Patient Stress Linked to More Advanced Leukemia

Patients with chronic lymphocytic leukemia (CLL) who experience more stress also have more cancer cells in their blood and elevated levels of three other advanced disease markers, according to results of a study published in Cancer. It is the first study to link stress with biologic disease markers in patients with CLL.

Researchers surveyed 96 patients with CLL about their cancer-related stress, asking questions such as how often they had intrusive thoughts about their cancer, how often they tried to avoid thinking about their cancer, and how often they felt jumpy and easily startled. The researchers also calculated patients’ absolute lymphocyte count and measured levels of eight different cytokines that are associated with immune response and inflammation.

They found that patients who reported the highest amounts of cancer-related stress had higher numbers of circulating cancer cells and higher levels of three cytokines: tumor necrosis factor alpha, interleukin-16, and chemokine ligand 3 (the latter fuels the development of CLL cells in the spleen and lymph nodes). Stress was linked to disease severity even after accounting for other factors such as gender, number of prior treatments, and the presence of del17p.